Name (Synonyms) | Correlation | |
---|---|---|
drug46 | Anakinra Wiki | 0.28 |
drug401 | Hydroxychloroquine, Doxycycline Wiki | 0.25 |
drug399 | Hydroxychloroquine, Clindamycin, Primaquine - high dose. Wiki | 0.25 |
drug794 | Streptokinase Wiki | 0.25 |
drug113 | Best Practice Wiki | 0.25 |
drug309 | Five-days oseltamivir Wiki | 0.25 |
drug962 | hydroxychloroquine in combination with camostat mesylate Wiki | 0.25 |
drug430 | Interferon-Alpha2B Wiki | 0.25 |
drug502 | MenACWY Wiki | 0.25 |
drug193 | Chloroquine analog (GNS651) Wiki | 0.25 |
drug311 | Fixed-duration higher dose Hydrocortisone Wiki | 0.25 |
drug491 | Macrolide administered for 3-5 days Wiki | 0.25 |
drug831 | Ten-days oseltamivir Wiki | 0.25 |
drug607 | Pembrolizumab (MK-3475) Wiki | 0.25 |
drug877 | Umbilical cord Wharton's jelly-derived human Wiki | 0.25 |
drug178 | Ceftaroline Wiki | 0.25 |
drug366 | Hydroxychloroquine + lopinavir/ritonavir Wiki | 0.25 |
drug219 | Continuous renal replacement therapy Wiki | 0.25 |
drug400 | Hydroxychloroquine, Clindamycin, Primaquine - low dose. Wiki | 0.25 |
drug210 | ColdZyme® mouth spray Wiki | 0.25 |
drug228 | Convalescent Serum Wiki | 0.25 |
drug518 | Moxifloxacin or Levofloxacin Wiki | 0.25 |
drug959 | hospitalized children with Covid19 Wiki | 0.25 |
drug492 | Macrolide administered for up to 14 days Wiki | 0.25 |
drug186 | ChAdOx1 nCoV-19 boost Wiki | 0.25 |
drug310 | Fixed-duration Hydrocortisone Wiki | 0.25 |
drug879 | Unfractionated heparin Wiki | 0.25 |
drug433 | Interferon-β1a Wiki | 0.25 |
drug185 | ChAdOx1 nCoV-19 Wiki | 0.25 |
drug747 | Shock-dependent hydrocortisone Wiki | 0.25 |
drug179 | Ceftriaxone Wiki | 0.25 |
drug535 | NaCl 0.9% Wiki | 0.25 |
drug45 | Amoxicillin-clavulanate Wiki | 0.25 |
drug393 | Hydroxychloroquine in combination of Azithromycin Wiki | 0.25 |
drug397 | Hydroxychloroquine, Azithromycin Wiki | 0.25 |
drug615 | Piperacillin-tazobactam Wiki | 0.25 |
drug398 | Hydroxychloroquine, Clindamycin Wiki | 0.25 |
drug555 | Nivolumab Wiki | 0.18 |
drug507 | Methylprednisolone Wiki | 0.18 |
drug748 | Siltuximab Wiki | 0.18 |
drug775 | Standard of care Wiki | 0.18 |
drug330 | HB-adMSCs Wiki | 0.18 |
drug691 | Remdesivir Wiki | 0.15 |
drug883 | Usual Care Wiki | 0.13 |
drug732 | Sarilumab Wiki | 0.10 |
drug480 | Losartan Wiki | 0.09 |
drug478 | Lopinavir/ritonavir Wiki | 0.08 |
drug632 | Placebos Wiki | 0.07 |
drug360 | Hydroxychloroquine Wiki | 0.06 |
drug82 | Azithromycin Wiki | 0.05 |
drug616 | Placebo Wiki | 0.03 |
Name (Synonyms) | Correlation | |
---|---|---|
D009362 | Neoplasm Metastasis NIH | 0.25 |
D007676 | Kidney Failure, Chronic NIH | 0.25 |
D055501 | Macrophage Activation Syndrome NIH | 0.25 |
D009369 | Neoplasms, NIH | 0.19 |
D020521 | Stroke NIH | 0.18 |
D003139 | Common Cold NIH | 0.18 |
D003324 | Coronary Artery Disease NIH | 0.18 |
D029424 | Pulmonary Disease, Chronic Obstructive NIH | 0.14 |
D008173 | Lung Diseases, Obstructive NIH | 0.13 |
D013577 | Syndrome NIH | 0.12 |
D018352 | Coronavirus Infections NIH | 0.10 |
D018450 | Disease Progression NIH | 0.09 |
D011014 | Pneumonia NIH | 0.08 |
D055371 | Acute Lung Injury NIH | 0.08 |
D012127 | Respiratory Distress Syndrome, Newborn NIH | 0.08 |
D045169 | Severe Acute Respiratory Syndrome NIH | 0.07 |
D012128 | Respiratory Distress Syndrome, Adult NIH | 0.07 |
D007239 | Infection NIH | 0.06 |
D014777 | Virus Diseases NIH | 0.05 |
D011024 | Pneumonia, Viral NIH | 0.04 |
D003141 | Communicable Diseases NIH | 0.03 |
There are 16 clinical trials
REMAP-CAP is a randomised, embedded, multifactorial, adaptive platform trial for community-acquired pneumonia. The purpose of this study is to evaluate the effect of a range of interventions to improve outcome ofon patients admitted to intensive care with community-acquired pneumonia. In addition, REMAP-CAP provides and adaptive research platform for evaluation of multiple treatment modalities in the event of a respiratory pandemic resulting in critical illness. REMAP-COVID is a sub-platform of REMAP-CAP that evaluates treatments specific to COVID-19.
Description: Primary end-point for patients with suspected or proven COVID-19 pandemic infection
Measure: Days alive and outside of ICU Time: Day 21Description: EQ5D-5L and WHODAS 2.0 (not completed in all regions)
Measure: Health-related Quality of life assessment Time: 6 monthsDescription: Characterised as home, rehabilitation hospital, nursing home or long-term care facility, or another acute hospital
Measure: Destination at time of hospital discharge Time: Free text Day 90Description: Antibiotic Domain specific outcome
Measure: Occurrence of multi-resistant organism colonisation/infection Time: Day 90, censored at hospital dischargeDescription: Antibiotic Domain specific outcome
Measure: Occurrence clostridium difficile Time: Day 90, censored at hospital dischargeDescription: Macrolide Duration domain specific outcome, and COVID-19 Antiviral Domain specific outcome.
Measure: Occurrence of serious ventricular arrhythmia (including ventricular fibrillation) or sudden unexpected death Time: Day 90, censored at hospital dischargeDescription: Antiviral Domain specific outcome. Only required at selected sites.
Measure: Change from baseline influenza virus levels in upper and lower respiratory tract specimens Time: Day 3, up to Day 7Description: COVID-19 Antiviral Domain and COVID-19 Immune Modulation Domain specific endpoint
Measure: Serial detection of SARS-CoV-2 in upper or lower respiratory tract specimens (using only specimens collected for routine clinical testing) Time: Day 90, censored at hospital dischargeSome patients infected with the COVID-19 can develop uncontrolled immune response, leading to potentially life-threatening damage to lung tissue. Tocilizumab was first approved by the U.S. FDA in 2010 for rheumatoid arthritis and might now be used to treat serious COVID-19 patients with lung damage, according to China's National Health Commission updated its treatment guidelines in 7th version.Continuous Renal Replacement Therapy (CRRT) was recommended by China's National Health Commission treatment guidelines in 1st-7th version to control sever COVID-19 patients.
Description: This is a composite outcome measure. Criteria for fever normalization: Temperature < 36.6 °C armpit, < 37.2 °C oral sustained for at least 72 hours and criteria for oxygen normalization: peripheral capillary oxygen saturation (Sp02) > 94% sustained for at least 72 hours.
Measure: Proportion of Participants With Normalization of Fever and Oxygen Saturation Through Day 14 Time: First dose date up to 14 daysDescription: Measured in days
Measure: Duration of hospitalization Time: Up to 28 daysDescription: Criteria for: Temperature < 36.6 °C armpit, < 37.2 °C oral, or < 37.8 °C rectal sustained for at least 72 hours.
Measure: Proportion of Participants With Normalization of Fever Through Day 14 Time: First dose date up to 14 daysDescription: Blood routine test
Measure: Change from baseline in white blood cell and differential count Time: Day 1 through Day 28Description: Oropharyngeal or anal swabs
Measure: Time to first negative in 2019 novel Corona virus RT-PCR test Time: Up to 28 daysDescription: Date and cause of death (if applicable).
Measure: All-cause mortality Time: up to 12 weeksDescription: Serum hsCRP
Measure: Change from baseline in hsCRP Time: Day 1 through Day 28Description: Serum inflammatory cytokines
Measure: Change from baseline in cytokines IL-1β, IL-10, sIL-2R, IL-6, IL-8 and TNF-α Time: Day 1 through Day 28Description: Flow cytometry for peripheral whole blood
Measure: Change from baseline in proportion of CD4+CD3/CD8+CD3 T cells Time: Day 1 through Day 28 (if applicable)The purpose of this study is to test the safety and effectiveness of individually or simultaneously blocking IL-6 and IL-1 versus standard of care on blood oxygenation and systemic cytokine release syndrome in patients with COVID-19 coronavirus infection and acute hypoxic respiratory failure and systemic cytokine release syndrome
Description: defined as the time from randomization to either an improvement of two points on a six-category ordinal scale or discharge from the hospital: Death Hospitalized, on invasive mechanical ventilation or ECMO; Hospitalized, on non-invasive ventilation or high flow oxygen devices; Hospitalized, requiring supplemental oxygen Hospitalized, not requiring supplemental oxygen Not hospitalized
Measure: Time to Clinical Improvement Time: at day 15Description: defined as independece from supplemental oxygen
Measure: Time to improvement in oxygenation Time: during hospital admission (up to 28 days)Description: defined by Pa02/FiO2 ratio while breading room air
Measure: Mean change in oxygenation Time: day 1, day 15 or hospital discharge, whichever is firstDescription: Clinical sign score: 0( best) - 18 (worse)
Measure: Mean change in clinical sign score between day 1 and day 7 Time: day 1, day 7 or hospital discharge, whichever is firstDescription: Clinical sign score: 0( best) - 18 (worse)
Measure: Mean change in clinical sign score between day 1 and day 15 Time: day 1, day 15 or hospital discharge, whichever is firstDescription: Clinical sign score: 0( best) - 18 (worse)
Measure: Time to clinical sign score <6 maintained for 24h Time: during hospital admission (up to 28 days)Description: SOFA score: 0 (best) - 24 (worse)
Measure: Mean change of SOFA score (Sequential Organ Failure Assessment) between day 1 and day 7 Time: Day 1, day 7or hospital discharge, whichever is firstDescription: SOFA score: 0 (best) - 24 (worse)
Measure: Mean change of SOFA score between day 1 and day 15 Time: day 1, day 15 or hospital discharge, whichever is firstDescription: NEWS2 score: 0 (best) - 24 (worse)
Measure: Mean change NEWS2 (National Early Warning) score between day 1 and day 7 Time: day 1, day 7 or hospital discharge, whichever is firstDescription: NEWS2 score: 0 (best) - 24 (worse)
Measure: Mean change NEWS2 score between day 1 and day 15 Time: day 1, day 15 or hospital discharge, whichever is firstDescription: 6-point ordinal scale: Death Hospitalized, on invasive mechanical ventilation or ECMO; Hospitalized, on non-invasive ventilation or high flow oxygen devices; Hospitalized, requiring supplemental oxygen Hospitalized, not requiring supplemental oxygen Not hospitalized
Measure: Percentage of patients reporting each severity rating on a 6-point ordinal scale in relation to serum IL-1 Time: at day 15 or hospital discharge, whichever is firstDescription: 6-point ordinal scale: Death Hospitalized, on invasive mechanical ventilation or ECMO; Hospitalized, on non-invasive ventilation or high flow oxygen devices; Hospitalized, requiring supplemental oxygen Hospitalized, not requiring supplemental oxygen Not hospitalized
Measure: Percentage of patients reporting each severity rating on a 6-point ordinal scale in relation to serum IL-6 Time: at day 15 or hospital discharge, whichever is firstDescription: defined by Hs (Hemophagocytic Syndrome) score
Measure: incidence of secondary haemophagocytic lymphohistiocytosis Time: during hospital admission (up to 28 days)Description: defined by Hs score
Measure: Incidence of secondary haemophagocytic lymphohistiocytosisscore in relation to serum IL-1 Time: during hospital admission (up to 28 days)Description: defined by Hs score
Measure: Incidence of secondary haemophagocytic lymphohistiocytosis in relation to serum IL-6 Time: during hospital admission (up to 28 days)Coronavirus disease-2019 (COVID-19) has a quoted inpatient mortality as high as 25%. This high mortality may be driven by hyperinflammation resembling cytokine release syndrome (CRS), offering the hope that therapies targeting the interleukin-6 (IL-6) axis therapies commonly used to treat CRS can be used to reduce COVID-19 mortality. Retrospective analysis of severe to critical COVID-19 patients receiving tocilizumab demonstrated that the majority of patients had rapid resolution (i.e., within 24-72 hours following administration) of both clinical and biochemical signs (fever and CRP, respectively) of hyperinflammation with only a single tocilizumab dose. Hypotheses: 1. Tocilizumab is effective in decreasing signs, symptoms, and laboratory evidence of COVID-19 pneumonitis in hospitalized, non-critically ill patients with clinical risk factors for clinical decompensation, intensive care utilization, and death. 2. Low-dose tocilizumab is effective in decreasing signs, symptoms, and laboratory evidence of COVID-19 pneumonitis in hospitalized, non-critically ill patients with and without clinical risk factors for clinical decompensation, intensive care utilization, and death. Objectives: 1. To establish proof of concept that tocilizumab is effective in decreasing signs, symptoms, and laboratory evidence of COVID-19 pneumonitis in hospitalized, non-critically ill patients with clinical risk factors for clinical decompensation, intensive care utilization, and death, as determined by the clinical outcome of resolution of fever and the biochemical outcome measures of time to CRP normalization for the individual patient and the rate of patients whose CRP normalize. 2. To establish proof of concept that low-dose tocilizumab is effective in decreasing signs, symptoms, and laboratory evidence of COVID-19 pneumonitis in hospitalized, non-critically ill patients without clinical risk factors for clinical decompensation, intensive care utilization, and death, as determined by the clinical outcome of resolution of fever and the biochemical outcome measures of time to CRP normalization for the individual patient and the rate of patients whose CRP normalize.
Description: Tmax Response: Resolution of fever (from Tmax > 38C in 24H period to Tmax < 38C in following 24H period, with Tmax measured by commonly accepted clinical methods [forehead, tympanic, oral, axillary, rectal]). Maximum temperature within 24-hour period of time (0:00-23:59) on the day prior to, day of, and every 24 hours after tocilizumab administration. The primary endpoint is absence of Tmax greater than or equal to 38ºC in the 24-hour period following tocilizumab administration.
Measure: Clinical response Time: Assessed for the 24 hour period after tocilizumab administrationDescription: CRP normalization rate: Calculated as the ratio of the number of patients who achieve normal CRP value following tocilizumab administration and total number of patients who receive tocilizumab. Time to CRP normalization: Calculated as the number of hours between tocilizumab administration and first normal CRP value.
Measure: Biochemical response Time: Assessed every 24 hours during patient's hospitalization, up to 4 weeks after tocilizumab administrationDescription: 28-Day Overall Survival is defined as the status of the patient at the end of 28 days, beginning from the time of the first dose of tocilizumab.
Measure: Overall survival Time: 28 daysDescription: This will be defined as the percentage of patients who are discharged in stable condition compared to the percentage of patients who die in the hospital. Patients who are discharged to hospice will be excluded from this calculation.
Measure: Survival to hospital discharge Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a binary outcome defined by worsening COVID-19 pneumonitis resulting in transition from clinical Group A or Group B COVID-19 pneumonitis to critical COVID-19 pneumonitis during the course of the patient's COVID-19 infection. This diagnosis will be determined by treating physicians on the basis of worsening pulmonary infiltrates on chest imaging as well as clinical deterioration marked by persistent fever, rising supplemental oxygen requirement, declining PaO2/FiO2 ratio, and the need for intensive care such as mechanical ventilation or vasopressor/inotrope medication(s).
Measure: Progression of COVID-19 pneumonitis Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a binary outcome defined as worsening COVID-19 disease resulting in the use of non-invasive (BiPap, heated high-flow nasal cannula) or invasive positive pressure ventilation during the course of the patient's COVID-19 infection. For patients admitted to the hospital using non-invasive mechanical ventilation, the utilization of mechanical ventilation will count toward this metric, as well. Calculated as the ratio of the number of patients who require non-invasive or invasive positive pressure ventilation during hospitalization and total number of patients who receive tocilizumab.
Measure: Rate of non-elective mechanical ventilation Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a continuous outcome defined by the amount of time between initiation and cessation of mechanical ventilation (invasive and non-invasive).
Measure: Duration of mechanical ventilation Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a continuous outcome defined by the amount of time between tocilizumab dose administration and the initiation of mechanical ventilation. This will be treated as a time-to-event with possible censoring.
Measure: Time to mechanical ventilation Time: Assessed over hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a binary outcome defined as utilization of any vasopressor or inotropic medication during the course of the patient's COVID-19 infection. Calculated as the ratio of the number of patients who require vasopressor or inotrope medication during hospitalization and total number of patients who receive tocilizumab.
Measure: Rate of vasopressor/inotrope utilization Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a continuous outcome defined by the amount of time between initiation of first and cessation of last vasopressor or inotrope medication(s).
Measure: Duration of vasopressor/inotrope utilization Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a continuous outcome defined by the amount of time between first tocilizumab dose administration and the initiation of vasopressor or inotropic medication(s). This will be treated as a time-to-event with possible censoring.
Measure: Time to vasopressor or inotropic utilization Time: Assessed over hospitalization, up to 4 weeks after tocilizumab administrationDescription: Number of ICU days is defined as the time period when a patient is admitted to the ICU (defined as the timestamp on the first vital signs collected in an ICU) until they are transferred from the ICU to a non-ICU setting such as a general acute care bed (defined as the timestamp on the first vital signs collected outside an ICU, excepting any "off the floor" vital signs charted from operating rooms or procedure or imaging suites). Death in the ICU will be a competing risk.
Measure: Number of ICU days Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: Duration of increased supplemental oxygen requirement from baseline is defined as the time period (number of days) during which the participant requires supplemental oxygen in excess of his/her baseline supplemental oxygen requirement. The supplemental oxygen requirement is defined as the highest liters-per-minute flow of supplemental oxygen required by the patient each day over the course of the hospitalization.
Measure: Duration of Increased Supplemental Oxygen Requirement from Baseline Time: Assessed over hospitalization, up to 4 weeks after tocilizumab administrationCoronavirus disease-2019 (COVID-19) has a quoted inpatient mortality as high as 25%. This high mortality may be driven by hyperinflammation resembling cytokine release syndrome (CRS), offering the hope that therapies targeting the interleukin-6 (IL-6) axis therapies commonly used to treat CRS can be used to reduce COVID-19 mortality. Retrospective analysis of severe to critical COVID-19 patients receiving tocilizumab demonstrated that the majority of patients had rapid resolution (i.e., within 24-72 hours following administration) of both clinical and biochemical signs (fever and CRP, respectively) of hyperinflammation with only a single tocilizumab dose. Hypotheses: 1. Tocilizumab is effective in decreasing signs, symptoms, and laboratory evidence of COVID-19 pneumonitis in hospitalized, non-critically ill patients with clinical risk factors for clinical decompensation, intensive care utilization, and death. 2. Low-dose tocilizumab is effective in decreasing signs, symptoms, and laboratory evidence of COVID-19 pneumonitis in hospitalized, non-critically ill patients with and without clinical risk factors for clinical decompensation, intensive care utilization, and death. Objectives: 1. To establish proof of concept that tocilizumab is effective in decreasing signs, symptoms, and laboratory evidence of COVID-19 pneumonitis in hospitalized, non-critically ill patients with clinical risk factors for clinical decompensation, intensive care utilization, and death, as determined by the clinical outcome of resolution of fever and the biochemical outcome measures of time to CRP normalization for the individual patient and the rate of patients whose CRP normalize. 2. To establish proof of concept that low-dose tocilizumab is effective in decreasing signs, symptoms, and laboratory evidence of COVID-19 pneumonitis in hospitalized, non-critically ill patients without clinical risk factors for clinical decompensation, intensive care utilization, and death, as determined by the clinical outcome of resolution of fever and the biochemical outcome measures of time to CRP normalization for the individual patient and the rate of patients whose CRP normalize.
Description: Tmax Response: Resolution of fever (from Tmax > 38C in 24H period to Tmax < 38C in following 24H period, with Tmax measured by commonly accepted clinical methods [forehead, tympanic, oral, axillary, rectal]). Maximum temperature within 24-hour period of time (0:00-23:59) on the day prior to, day of, and every 24 hours after tocilizumab administration. The primary endpoint is absence of Tmax greater than or equal to 38ºC in the 24-hour period following tocilizumab administration.
Measure: Clinical response Time: Assessed for the 24 hour period after tocilizumab administrationDescription: CRP normalization rate: Calculated as the ratio of the number of patients who achieve normal CRP value following tocilizumab administration and total number of patients who receive tocilizumab. Time to CRP normalization: Calculated as the number of hours between tocilizumab administration and first normal CRP value.
Measure: Biochemical response Time: Assessed every 24 hours during patient's hospitalization, up to 4 weeks after tocilizumab administrationDescription: 28-Day Overall Survival is defined as the status of the patient at the end of 28 days, beginning from the time of the first dose of tocilizumab.
Measure: Overall survival Time: 28 daysDescription: This will be defined as the percentage of patients who are discharged in stable condition compared to the percentage of patients who die in the hospital. Patients who are discharged to hospice will be excluded from this calculation.
Measure: Survival to hospital discharge Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a binary outcome defined by worsening COVID-19 pneumonitis resulting in transition from clinical Group A or Group B COVID-19 pneumonitis to critical COVID-19 pneumonitis during the course of the patient's COVID-19 infection. This diagnosis will be determined by treating physicians on the basis of worsening pulmonary infiltrates on chest imaging as well as clinical deterioration marked by persistent fever, rising supplemental oxygen requirement, declining PaO2/FiO2 ratio, and the need for intensive care such as mechanical ventilation or vasopressor/inotrope medication(s).
Measure: Progression of COVID-19 pneumonitis Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a binary outcome defined as worsening COVID-19 disease resulting in the use of non-invasive (BiPap, heated high-flow nasal cannula) or invasive positive pressure ventilation during the course of the patient's COVID-19 infection. For patients admitted to the hospital using non-invasive mechanical ventilation, the utilization of mechanical ventilation will count toward this metric, as well. Calculated as the ratio of the number of patients who require non-invasive or invasive positive pressure ventilation during hospitalization and total number of patients who receive tocilizumab.
Measure: Rate of non-elective mechanical ventilation Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a continuous outcome defined by the amount of time between initiation and cessation of mechanical ventilation (invasive and non-invasive).
Measure: Duration of mechanical ventilation Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a continuous outcome defined by the amount of time between tocilizumab dose administration and the initiation of mechanical ventilation. This will be treated as a time-to-event with possible censoring.
Measure: Time to mechanical ventilation Time: Assessed over hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a binary outcome defined as utilization of any vasopressor or inotropic medication during the course of the patient's COVID-19 infection. Calculated as the ratio of the number of patients who require vasopressor or inotrope medication during hospitalization and total number of patients who receive tocilizumab.
Measure: Rate of vasopressor/inotrope utilization Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a continuous outcome defined by the amount of time between initiation of first and cessation of last vasopressor or inotrope medication(s).
Measure: Duration of vasopressor/inotrope utilization Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: This will be a continuous outcome defined by the amount of time between first tocilizumab dose administration and the initiation of vasopressor or inotropic medication(s). This will be treated as a time-to-event with possible censoring.
Measure: Time to vasopressor or inotropic utilization Time: Assessed over hospitalization, up to 4 weeks after tocilizumab administrationDescription: Number of ICU days is defined as the time period when a patient is admitted to the ICU (defined as the timestamp on the first vital signs collected in an ICU) until they are transferred from the ICU to a non-ICU setting such as a general acute care bed (defined as the timestamp on the first vital signs collected outside an ICU, excepting any "off the floor" vital signs charted from operating rooms or procedure or imaging suites). Death in the ICU will be a competing risk.
Measure: Number of ICU days Time: Hospitalization, up to 4 weeks after tocilizumab administrationDescription: Duration of increased supplemental oxygen requirement from baseline is defined as the time period (number of days) during which the participant requires supplemental oxygen in excess of his/her baseline supplemental oxygen requirement. The supplemental oxygen requirement is defined as the highest liters-per-minute flow of supplemental oxygen required by the patient each day over the course of the hospitalization.
Measure: Duration of Increased Supplemental Oxygen Requirement from Baseline Time: Assessed over hospitalization, up to 4 weeks after tocilizumab administrationThe overall objective of the study is to determine the therapeutic effect and tolerance of Tocizilumab in patients with moderate, severe pneumonia or critical pneumonia associated with Coronavirus disease 2019 (COVID-19). Tocilizumab (TCZ) is an anti-human IL-6 receptor monoclonal antibody that inhibits signal transduction by binding sIL-6R and mIL-6R. The study has a cohort multiple Randomized Controlled Trials (cmRCT) design. Randomization will occur prior to offering Tocilizumab administration to patients enrolled in the COVIMUNO-19 cohort. Tocilizumab will be administered to consenting adult patients hospitalized with CORVID-19 either diagnosed with moderate or severe pneumonia requiring no mechanical ventilation or critical pneumonia requiring mechanical ventilation. Patients who will chose not to receive Tocilizumab will receive standard of cares. Outcomes of Tocilizumab-treated patients will be compared with outcomes of standard of care treated patients as well as outcomes of patients treated with other immune modulators.
Description: Group 1. Survival without needs of ventilator utilization (including non invasive ventilation and high flow) at day 14. Thus, events considered are needing ventilator utilization (including Non Invasive Ventilation, NIV or high flow), or death. New DNR order (if given after the inclusion of the patient) will be considered as an event at the date of the DNR.
Measure: Survival without needs of ventilator utilization at day 14. Group 1 Time: 14 daysDescription: Group 1. Proportion of patients alive without non-invasive ventilation of high low at day 4 (WHO progression scale ≤ 5). A patient with new DNR order at day 4 will be considered as with a score > 5. WHO progression scale: Uninfected; non viral RNA detected: 0 Asymptomatic; viral RNA detected: 1 Symptomatic; Independent: 2 Symptomatic; Assistance needed: 3 Hospitalized; No oxygen therapy: 4 Hospitalized; oxygen by mask or nasal prongs: 5 Hospitalized; oxygen by NIV or High flow: 6 Intubation and Mechanical ventilation, pO2/FIO2>=150 OR SpO2/FIO2>=200: 7 Mechanical ventilation, (pO2/FIO2<150 OR SpO2/FIO2<200) OR vasopressors (norepinephrine >0.3 microg/kg/min): 8 Mechanical ventilation, pO2/FIO2<150 AND vasopressors (norepinephrine >0.3 microg/kg/min), OR Dialysis OR ECMO: 9 Dead: 10
Measure: WHO progression scale <=5 at day 4. Group 1. Time: 4 daysDescription: Group 2. Cumulative incidence of successful tracheal extubation (defined as duration extubation > 48h) at day 14 if patients have been intubated before day 14 ; or removal of NIV or high flow (for > 48h) if they were included under oxygen by NIV or High flow (score 6) and remained without intubation. Death or new DNR order (if given after the inclusion of the patient) will be considered as a competing event.
Measure: Cumulative incidence of successful tracheal extubation (defined as duration extubation > 48h) at day 14. Group 2. Time: 14 daysDescription: Group 2 Early end point : proportion of patients with a decrease of WHO score of at least 1 point at day 4. WHO progression scale: Uninfected; non viral RNA detected: 0 Asymptomatic; viral RNA detected: 1 Symptomatic; Independent: 2 Symptomatic; Assistance needed: 3 Hospitalized; No oxygen therapy: 4 Hospitalized; oxygen by mask or nasal prongs: 5 Hospitalized; oxygen by NIV or High flow: 6 Intubation and Mechanical ventilation, pO2/FIO2>=150 OR SpO2/FIO2>=200: 7 Mechanical ventilation, (pO2/FIO2<150 OR SpO2/FIO2<200) OR vasopressors (norepinephrine >0.3 microg/kg/min): 8 Mechanical ventilation, pO2/FIO2<150 AND vasopressors (norepinephrine >0.3 microg/kg/min), OR Dialysis OR ECMO: 9 Dead: 10
Measure: WHO progression scale at day 4. Group 2. Time: 4 daysDescription: WHO progression scale: Uninfected; non viral RNA detected: 0 Asymptomatic; viral RNA detected: 1 Symptomatic; Independent: 2 Symptomatic; Assistance needed: 3 Hospitalized; No oxygen therapy: 4 Hospitalized; oxygen by mask or nasal prongs: 5 Hospitalized; oxygen by NIV or High flow: 6 Intubation and Mechanical ventilation, pO2/FIO2>=150 OR SpO2/FIO2>=200: 7 Mechanical ventilation, (pO2/FIO2<150 OR SpO2/FIO2<200) OR vasopressors (norepinephrine >0.3 microg/kg/min): 8 Mechanical ventilation, pO2/FIO2<150 AND vasopressors (norepinephrine >0.3 microg/kg/min), OR Dialysis OR ECMO: 9 Dead: 10
Measure: WHO progression scale Time: 7 and 14 daysDescription: Overall survival
Measure: Survival Time: 14, 28 and 90 daysDescription: arterial blood pH of <7.25 with a partial pressure of arterial carbon dioxide [Paco2] of ≥60 mm Hg for >6 hours
Measure: respiratory acidosis at day 4 Time: 4 daysDescription: evolution of PaO2/FiO2 ratio
Measure: PaO2/FiO2 ratio Time: day 1 to day 14Description: time to oxygen supply independency
Measure: time to oxygen supply independency Time: 14 daysDescription: duration of hospitalization
Measure: duration of hospitalization Time: 90 daysDescription: time to negative viral excretion
Measure: time to negative viral excretion Time: 90 daysDescription: time to ICU discharge
Measure: time to ICU discharge Time: 90 daysDescription: time to hospital discharge
Measure: time to hospital discharge Time: 90 daysCOVID-19 is a respiratory disease caused by the new coronavirus (SARS-CoV-2) and causes considerable morbidity and mortality. Currently, there is no vaccine or therapeutic agent to prevent and treat a SARS-CoV-2 infection. This clinical trial is designed to evaluate the use of Tocilizumab in combination with hydroxychloroquine and azithromycin for the treatment of hospitalized adult patients with COVID-19.
A prospective, controlled, randomized, multicenter study whose goal is to compare the efficacy of a chloroquine analog (GNS561), an anti PD-1 (nivolumab) and an anti-interleukine-6 receptor (tocilizumab) versus standard of care in patients with advanced or metastatic cancer who have Sars-CoV-2 infection not eligible to a resuscitation unit. According to their severity level at the time of enrolment, eligible patients will be randomized into 2 different cohorts: - COHORT 1 (mild symptoms or asymptomatic): GNS561 vs anti-PD1 vs standard of care (randomization ratio 1:1:1). - COHORT 2 (moderate/severe symptoms): GNS561 vs anti-IL6 vs standard of care (randomization ratio 1:1:1).
Description: 28-day survival rate, defined by the proportion of patients still alive 28 days after randomization. The 28-day survival rate will be described in each arm of each cohort.
Measure: 28-day survival rate Time: 28 days from randomizationDescription: Time to clinical improvement defined as the time from randomization to an improvement of two points (from the status at randomization) on a seven-category ordinal scale (WHO-ISARIC) or live discharge from the hospital, whichever comes first.
Measure: Time to clinical improvement Time: 28 days from randomizationDescription: Clinical status will be assessed using a 7-point ordinal scale : Not hospitalized, no limitations on activities Not hospitalized, limitation on activities; Hospitalized, not requiring supplemental oxygen; Hospitalized, requiring supplemental oxygen; Hospitalized, on non-invasive ventilation or high flow oxygen devices; Hospitalized, on invasive mechanical ventilation or ECMO; Death.
Measure: Clinical status Time: Day 7, Day 14, Day 28Description: Mean change in clinical status from baseline will be assessed using a 7-point ordinal scale.
Measure: Mean change in clinical status from baseline to days Time: Day 7, Day 14, Day 28Description: Overall survival will be defined by the time from date of randomization until date of death, regardless of the cause. Any patient not known to have died at the time of analysis will be censored based on the last recorded date on which the patient was known to be alive.
Measure: Overall survival Time: 3 months (i.e. at the the time of last patient last visit)Description: The length of stay in Intensive Care Unit (from the date of admission in the Unit to the date of discharge).
Measure: Length of stay in Intensive Care Unit Time: 3 months (i.e. at the the time of last patient last visit)Description: The duration of mechanical ventilation or high flow oxygen devices (from the date of intubation to the stop date of mechanical ventilation or high flow oxygen)
Measure: Duration of mechanical ventilation or high flow oxygen devices Time: 3 months (i.e. at the the time of last patient last visit)Description: The duration of hospitalization (from the date of hospitalization to the date of definitive discharge for live patients)
Measure: Duration of hospitalization Time: 3 months (i.e. at the the time of last patient last visit)Description: Changes from baseline in neutrophils count (G/L)
Measure: Biological parameters Time: 3 months (i.e. at the the time of last patient last visit)Description: Treatment-Emergent Adverse Events, Serious Adverse Events, Suspected Unexpected Serious Adverse Reactions, New Safety Issues described using the NCI-CTC AE classification v5. Number of participants with a discontinuation or temporary suspension of study drugs (for any reason).
Measure: Number of participants with treatment-related adverse events as assessed by CTCAE v5.0 Time: 3 months (i.e. at the the time of last patient last visit)Description: Incremental Cost-Effectiveness Ratios (ICERs) expressed in cost per Life Year Gained.
Measure: Cost-Effectiveness Analyses (CEA) Time: 3 months (i.e. at the the time of last patient last visit)Description: Changes from baseline in lymphocytes count (G/L)
Measure: Biological parameters Time: 3 months (i.e. at the the time of last patient last visit)Description: Changes from baseline in platelets count (G/L)
Measure: Biological parameters Time: 3 months (i.e. at the the time of last patient last visit)Description: Changes from baseline in hemoglobin count (g/dL)
Measure: Biological parameters Time: 3 months (i.e. at the the time of last patient last visit)Description: Changes from baseline in CRP count (mg/L)
Measure: Biological parameters Time: 3 months (i.e. at the the time of last patient last visit)Description: Changes from baseline in pro-inflammatory cytokine (IL6)
Measure: Biological parameters Time: 3 months (i.e. at the the time of last patient last visit)This is a prospective, multicenter, randomized, controlled, open-label, phase 2 clinical trial
Description: Assessed by hospital records
Measure: Percentage of patients with normalization of oxygen saturation by pulse oximetry (SpO2) ≥96% Time: through day 14 after study treatment initiationDescription: Assessed by hospital records
Measure: Proportion of patients with temperature < 37,5 °C armpit. Time: through day 14 after study treatment initiationDescription: Assessed by hospital records
Measure: Proportion of patients discharged from the emergency department and classified as low risk Time: In less than 28 daysDescription: The clinical status will be assessed by the SOFA scores
Measure: Change from baseline in organ failure parameters Time: Days 1, 3, 5, 7, 14 (+/- 1 day) and 28 (+/- 2 days) or until discharge whatever it comes first.Description: Determined as percentage of dead patients
Measure: Proportion of mortality rate Time: Day 28Description: Determined as: Time to invasive mechanical ventilation (if not previously initiated); Time to independence from non-invasive mechanical ventilation; Time to independence from oxygen therapy.
Measure: Analysis of the remission of respiratory symptoms Time: Up to 3 months after last dose of treatmentDescription: by using the same imaging technique (chest X-ray or thoracic CT scan)
Measure: Evaluation of the radiological response Time: at days 1 and 28 (+/- 2 days)Description: determined using oropharyngeal or anal swabs
Measure: Time to first negative in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR test Time: within 28 days from study inclusionDescription: Baseline defined as the value collected at day 1, 2 hours before treatment administration
Measure: Change from baseline of absolute lymphocyte count (ALC),white blood cell count and white blood cell differential count Time: days 3, 5, 7, 10, 14 and 28 after administration of study drugDescription: Baseline defined as the value collected at day 1, 2 hours before treatment administration
Measure: Change from baseline of hemoglobin Time: days 3, 5, 7, 10, 14 and 28 after administration of study drugDescription: Baseline defined as the value collected at day 1, 2 hours before treatment administration
Measure: Change from baseline of platelets Time: days 3, 5, 7, 10, 14 and 28 after administration of study drugDescription: Baseline defined as the value collected at day 1, 2 hours before treatment administration
Measure: Change from baseline of activated partial thromboplastin time (aPTT) Time: days 3, 5, 7, 10, 14 and 28 after administration of study drugDescription: Baseline defined as the value collected at day 1, 2 hours before treatment administration
Measure: Change from baseline of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) Time: days 3, 5, 7, 10, 14 and 28 after administration of study drugDescription: Baseline defined as the value collected at day 1, 2 hours before treatment administration
Measure: Change from baseline of creatinine Time: days 3, 5, 7, 10, 14 and 28 after administration of study drugDescription: Baseline defined as the value collected at day 1, 2 hours before treatment administration
Measure: Change from baseline of glucose Time: days 3, 5, 7, 10, 14 and 28 after administration of study drugDescription: Baseline defined as the value collected at day 1, 2 hours before treatment administration
Measure: Change from baseline of total bilirubin Time: days 3, 5, 7, 10, 14 and 28 after administration of study drugDescription: Baseline defined as the value collected at day 1, 2 hours before treatment administration
Measure: Change from baseline of albumin Time: days 3, 5, 7, 10, 14 and 28 after administration of study drugDescription: Evaluated using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v.5.0), SOFA scores.
Measure: Incidence of adverse events (AEs), incidence of prespecified AEs (safety and tolerability) Time: Up to 28 days after last dose of treatmentOur aim is to conduct one trial of personalized immunotherapy in patients with SARS-CoV-2 (COVID-19) associated with organ dysfunction and with laboratory findings of macrophage activation syndrome or immune dysregulation. These patients will be selected by the use of a panel of biomarkers and laboratory findings and they will be allocated to immunotherapy treatment according to their needs.
Description: At least 25% decrease between baseline sequential organ failure assessment SOFA score and measured sequential organ failure assessment SOFA score at Study Day 8
Measure: Change of baseline total sequential organ failure assessment (SOFA) score Time: Visit study day 8Description: Resolution of all criteria of lower respiratory tract involvemed that led to study inclusion (except findings from imaging studies) at Study Day 8
Measure: Improvement of lung involvement measurements Time: Visit study day 8Description: At least 50% increase of pO2/FiO2 ratio between baseline and study visit Day 8
Measure: Increase of pO2/FiO2 ratio Time: Visit Study Day 8Description: Change of total sequential organ failure assessment (SOFA) score between baseline and study visit day 8 will be compared with historical comparators from Hellenic Sepsis Study Group Database (Sequential organ failure assessment range 0-24, high score associated with worst outcome)
Measure: Comparison of change of baseline total sequential organ failure assessment (SOFA) score in enrolled subjects towards historical comparators Time: Screening, Day 8Description: Change of lung involvement measurements between baseline and study visit day 8 will be compared with historical comparators from Hellenic Sepsis Study Group Database
Measure: Comparison of change of lung involvement measurements in enrolled subjects towards historical comparators Time: Screening, Day 8Description: Comparison of increase in pO2/FiO2 ratio towards historical comparators from Hellenic Sepsis Study Group Database
Measure: Comparison of pO2/FiO2 ratio in enrolled subjects towards historical comparators Time: Screening, Day 8Description: Change of Sequential organ failure assessment (SOFA) score on day 28 (Sequential organ failure assessment range 0-24, high score associated with worst outcome)
Measure: Change of sequential organ failure assessment (SOFA) score Time: Day 28Description: Mortality on day 28
Measure: Rate of Mortality Time: Day 28Description: Mortality on day 90
Measure: Rate of Mortality Time: Day 90Description: Cytokine stimulation from peripheral blood mononuclear cells will be compared between days 0 and 4
Measure: Cytokine stimulation Time: Screening, Day 4Description: Gene expression of peripheral blood mononuclear cells will be compared between days 0 and 4
Measure: Gene expression Time: Screening, Day 4Description: Change of serum/plasma proteins between days 0 and 4
Measure: Serum/plasma proteins Time: Screening, Day 4Description: Classification of immune function of screened patients who are not enrolled in study drug since they are not characterized with MAS or immune dysregulation
Measure: Classification of the immune function Time: ScreeningThis study aims to compare the efficacy and safety of Methylprednisolone versus Tocilizumab in improving clinical outcomes and reducing the need for ventilator support in COVID-19 patients with moderate COVID-19 disease at risk for complications of cytokine storm. Approximately 310 participants hospitalized with COVID-19 in UMMC, Hospital Sungai Buloh, Hospital Kuala Lumpur and Hospital Tuanku Jaafar will be enrolled into this study. Eligible participants will be selected based on a set of clinical, laboratory and radiological parameters indicative of early stages of CRS and lung function decline prior to being randomized at a ratio of 1:1 to receive either Tocilizumab or Methylprednisolone. Participants will be monitored daily for clinical and laboratory parameters, and at 48 hours, switched to the alternate study arm should they manifest signs and symptoms indicative of decompensation.
Diagnostic determination of disease and treatment responses has been limited to qualitative imaging, measurement of serum markers of disease, and sampling of tissue. In each of these instances, there is a built in error either due to sensitivity and specificity issues, clinician interpretation of results, or acceptance of the use of an indirect marker (blood test) of what is happening elsewhere in the body - at the tissue level. The Fleming Method for Tissue and Vascular Differentiation and Metabolism (FMTVDM) using same state single or sequential quantification comparisons [1] provides the first and only patented test (#9566037) - along with the associated submitted patent applications ruled to be covered under #9566037 - that quantitatively measures changes in tissue resulting from inter alia a disease process. This includes inter alia coronary artery disease (CAD), cancer and infectious/inflammatory processes including CoVid-19 pneumonia (CVP) resulting from the metabolic and regional blood flow differences (RBFDs) caused by these diseases. The purpose of this paper is to make clinicians and researchers aware of this proposed method for investigating the prevalence and severity of CVP - in addition to providing rapid determination of treatment response in each patient, directing treatment decisions; thereby reducing the loss of time, money, resources and patient lives.
Description: Measured improvement in tissue as measured using FMTVDM
Measure: Improvement in FMTVDM Measurement with nuclear imaging. Time: 72 hoursDescription: Extubation
Measure: Ventilator status Time: 7 daysDescription: Self explanatory
Measure: Survival status Time: 30 daysThis is a randomized, double blind, multi-center study to evaluate the effects of tocilizumab compared to placebo on patient outcomes in participants with confirmed SARS-CoV-2 infection and evidence of systemic inflammation. Participants will complete screening procedures, where inclusion and exclusion criteria will be evaluated. After screening, participants who meet all inclusion criteria and none of the exclusion criteria will be randomized 2:1 to tocilizumab or placebo. Participants will be followed for safety for 28 days after the last dose of study drug. We anticipate enrolling between 300 patients admitted to Massachusetts General Hospital (and additional Partners sites, after approval, including BWH, NSMC, and the NWH) into the trial.
Description: tocilizumab can decrease progression of COVID-19 associated respiratory failure necessitating ICU admission.
Measure: Proportion of patients that require mechanical ventilation Time: 28 daysDescription: Assessed at day 7, 14, 28 or day of discharge.Defined as moving up 2 levels on the following scale
Measure: 8-level Clinical improvement Scale Time: 28 daysDescription: Time to hospital discharge
Measure: Hospital discharge Time: 28 daysDescription: Mortality at day 7, 14 and 28
Measure: Mortality Time: 28 daysDescription: Duration of ICU stay (up to Day 28)
Measure: Duration of ICU stay Time: 28 daysDescription: The proportion of patients who require renal replacement therapy or have doubling of creatinine from baseline at Day 14 and Day 28
Measure: The proportion of patients who require renal replacement therapy or have doubling of creatinine Time: 28 daysThis phase III trial compares the effect of adding tocilizumab to standard of care versus standard of care alone in treating cytokine release syndrome (CRS) in patients with SARS-CoV-2 infection. CRS is a potentially serious disorder caused by the release of an excessive amount of substance that is made by cells of the immune system (cytokines) as a response to viral infection. Tocilizumab is used to decrease the body's immune response. Adding tocilizumab to standard of care may work better in treating CRS in patients with SARS-CoV-2 infection compared to standard of care alone.
Description: The 7-day length of invasive MV for each arm will be estimated with 95% confidence intervals (CIs) using the exact binomial distribution. Their difference by the arms will be tested by Cochran-Mantel-Haenszel (CMH) test stratified by the age group and Sequential Organ Failure Assessment (SOFA) score at significance level of 0.05.
Measure: 7-day length of invasive mechanical ventilation (MV) Time: Up to 7 daysDescription: Defined as death within 30-day after randomization. The 30-day mortality rate for each arm will be estimated with 95% CIs using the exact binomial distribution. Their difference by the arms will be tested CMH test stratified by the age group and SOFA score at significance level of 0.05.
Measure: 30-day mortality rate Time: Up to 30-day after randomizationDescription: The rate of ICU transfer for each arm will be estimated with 95% CIs using the exact binomial distribution. Their difference by the arms will be tested CMH test stratified by the age group and SOFA score at significance level of 0.05.
Measure: Rate of intensive care (ICU) transfer Time: Up to 2 yearsDescription: The rate of invasive mechanical ventilation for each arm will be estimated with 95% CIs using the exact binomial distribution. Their difference by the arms will be tested CMH test stratified by the age group and SOFA score at significance level of 0.05.
Measure: Rate of invasive mechanical ventilation Time: Up to 2 yearsDescription: The rate of tracheostomy for each arm will be estimated with 95% CIs using the exact binomial distribution. Their difference by the arms will be tested CMH test stratified by the age group and SOFA score at significance level of 0.05.
Measure: Rate of tracheostomy Time: Up to 2 yearsDescription: Will first be described by median and inter-quartile, and then compared between two arms by Wilcoxon Sum-Rank test
Measure: Length of ICU stay Time: Up to 2 yearsA phase II clinical trial will be carried out with the objective of studying the impact of the administration of Tocilizumab on the evolution of the acute respiratory distress syndrome (ARDS) in patients with severe or critical SARS-CoV-2 infection. Due to the high mortality of severe forms of SARS-CoV-2 and for ethical reasons, a control arm will not be included. Patients will be recruited by signing an informed consent and the baseline variables of interest will be recorded. Tocilizumab will be administered in one or two doses, depending on the case, and will be followed up for 30 days. The response to treatment, survival and evolution will be studied. Factors associated with improvement of ARDS and survival will be identified through multivariate analyzes. The results will be compared with those reported internationally.
Description: Until removal of mechanical ventilation, Control of hemoglobin, hematocrit, platelet , and leukocytes levels.
Measure: Hematic biometry Time: 24 hoursDescription: Until removal of mechanical ventilation. Control of glucose, uric acid, cholesterol, urea, triglycerides, and creatinine.
Measure: Blood chemistry Time: 24 hoursDescription: Until removal of mechanical ventilation. Control metabolic and repiratory alcalosis or acidosis.
Measure: Blood gas Time: 24 hoursDescription: Until removal of mechanical ventilation, Control of hemoglobin, hematocrit, platelet , and leukocytes levels.
Measure: Hematic biometry Time: 48 hoursDescription: Until removal of mechanical ventilation. Control of glucose, uric acid, cholesterol, urea, triglycerides, and creatinine.
Measure: Blood chemistry Time: 48 hoursDescription: Until removal of mechanical ventilation. Control metabolic and repiratory alcalosis or acidosis.
Measure: blood gas Time: 48 hoursDescription: Until removal of mechanical ventilation, Control of hemoglobin, hematocrit, platelet , and leukocytes levels.
Measure: Hematic biometry Time: 72 hoursDescription: Until removal of mechanical ventilation. Control of glucose, uric acid, cholesterol, urea, triglycerides, and creatinine.
Measure: Blood chemistry Time: 72 hoursDescription: Until removal of mechanical ventilation. Control metabolic and repiratory alcalosis or acidosis.
Measure: blood gas Time: 72 hoursDescription: Until removal of mechanical ventilation, Control of hemoglobin, hematocrit, platelet , and leukocytes levels.
Measure: Hematic biometry Time: 7 daysDescription: Until removal of mechanical ventilation. Control of glucose, uric acid, cholesterol, urea, triglycerides, and creatinine.
Measure: Blood chemistry Time: 7 daysDescription: Until removal of mechanical ventilation. Control metabolic and repiratory alcalosis or acidosis.
Measure: blood gas Time: 7 daysDescription: Until removal of mechanical ventilation, Control of hemoglobin, hematocrit, platelet , and leukocytes levels.
Measure: Hematic biometry Time: 14 daysDescription: Until removal of mechanical ventilation. Control of glucose, uric acid, cholesterol, urea, triglycerides, and creatinine.
Measure: Blood chemistry Time: 14 daysDescription: Until removal of mechanical ventilation. Control metabolic and repiratory alcalosis or acidosis.
Measure: blood gas Time: 14 daysDescription: Until removal of mechanical ventilation. Monitoring for signs of pneumonia imaging.
Measure: thorax radiography Time: 24 hoursDescription: Until removal of mechanical ventilation. Monitoring for signs of pneumonia imaging.
Measure: thorax radiography Time: 7 daysDescription: Until removal of mechanical ventilation. Monitoring for signs of pneumonia imaging.
Measure: thorax radiography Time: 14 daysThis phase II trial studies how well tocilizumab works in reducing the serious symptoms of and preventing future complications in patients with cancer and COVID-19. COVID-19 is caused by the SARS-CoV-2 virus. COVID-19 can be associated with a response by the immune system which may also cause symptoms of COVID-19 to worsen. This inflammation may be called "cytokine storm," which can cause widespread problems in the body. Tocilizumab is a medicine designed to block the action of a protein called interleukin-6 (IL-6) that is involved with the immune system and is known to be a key factor for problems with the immune system attacking the body. Tocilizumab is effective in treating "cytokine storm" from a type of cancer immunotherapy and may be effective in reducing the inflammatory response and "cytokine storm" seen in severe COVID-19 disease. Treating the inflammation may help to reduce symptoms, improve the ability to breath without a breathing machine (ventilator), and prevent patients from having more complications.